Professional liability (malpractice) coverage of humanist scholars functioning as clinical medical ethicists

In contrast to theoretical discussions about potential professional liability of clinical ethicists, this report gives the results of empirical data gathered in a national survey of clinical medical ethicists. The report assesses the types of activities of clinical ethicists, the extent and types of their professional liability coverage, and the influence that concerns about legal liability has on how they function as clinical ethicists. In addition demographic data on age, sex, educational background, etc. are reported. The results show that while nearly one third (28.9%) of the ethicists regularly make recommendations about patient care, only 10.8% of them regularly make entries in the medical record; only approximately half (53.0%) of them are covered by professional liability (malpractice) insurance; and the vast majority (84.3%) of them say that concerns about legal liability do not influence the way they function as clinical ethicists.     

The Effect of Contextual Factors on Individuals' Job Performance

The intent of this study is to apply a cross-level design to examine the influence of contextual factors upon individuals' performance. The results support the hypothesis that peer group characteristics predict individual performance beyond individual characteristics. The implications for using a cross-level approach to study the effects of contextual variables on individual-level phenomena are discussed.     

Noncompliance with Persuasive Appeals for a Prosocial,Altruistic Act: Blood Donating1

Effects of persuasive messages, responsibility denial (RD), and attitude-accessing on blood-giving attitudes, intentions, moral obligations, and behavior were examined. In Study 1, participants (n= 84) who heard a message emphasizing moral reasons for donating indicated a more favorable postmessage attitude and stronger moral obligation to donate than participants exposed to a message aimed at reducing fear, a combined moral and fear- reduction message, or no message. Combined message participants showed greatest intent to donate, yet only 14% of all participants attended a campus drive. In Study 2, low (n= 52) and high (n= 60) RD individuals heard the message arguments and were asked to access their attitudes. Low compared to high RD individuals stated a stronger sense of moral obligation, particularly when they accessed their thoughts relevant to blood donating, and behavioral intention, especially in the combined message condition. Few participants attended a blood drive (12.5%), yet most were low RD individuals from the nonaccessed attitude condition (83%). Results suggest that few individuals will engage in the altruistic act of blood donating, despite the experimental use of persuasive messages and accessing issue-relevant attitudes.     

COMPARISON OF STAFF TRAINING STRATEGIES TO PROMOTE GENERALIZED TEACHING SKILLS

Two studies compared the effectiveness of different strategies for promoting generalization of staff skills in teaching self-care routines to clients with developmental disabilities. In Study 1, 9 direct-care staff members of group homes were trained sequentially through four conditions: (a) the provision of written instructions, (b) performance-based training using a single client program exemplar and simulated clients (single case training), (c) performance-based training using actual developmentally delayed clients as trainees (common stimuli training), and (d) performance-based training using multiple client program exemplars with simulated clients (general case training). The results indicated that staff members did not reach all generalization criteria until general case training was provided. Because staff members had been trained sequentially through several conditions in Study 1, a second study controlled for potential sequence effects. In Study 2, 7 staff members were trained using only the general case strategy after baseline. All staff members reached generalization criteria with only general case training, replicating the findings of Study 1. Together, the two studies demonstrated that the general case training strategy was more effective at promoting generalized training effects across clients, settings, and client programs than other commonly used staff training approaches.     

Acoustic analysis in the differentiation of Parkinson's disease and major depression

In its early stages, Parkinson's disease (P.D.) may be difficult to distinguish from major depression (M.D.) leading to inappropriate management. Both illnesses are characterized by psychomotor retardation. The neurovegetative symptoms used to diagnose M.D. are not specific and in P.D. may be due to the physical illness itself. Currently, differentiation of the two disorders relies on subjective clinical observation. Improved diagnostic accuracy based on more objective data is needed. To this end, this study used computerized acoustic analysis to contrast speech patterns in P.D. and M.D. The sample consisted of 30 P.D. patients without depression or dementia, 30 patients with uncomplicated M.D., and 31 normal controls, each 60 years of age or over. Of the acoustic variables studied, M.D. patients had significantly reduced rates of speech compared with P.D. patients. The data suggest that this temporal measure of speech may be useful in the differentiation of P.D. and M.D.     

Visual hemispheric asymmetries depend on which spatial frequencies are task relevant

Observers classified sine-wave and square-wave gratings on the basis of fundamental frequency (Are the bars wide or narrow?) or on the basis of higher harmonic frequencies (Are the bars sharp or fuzzy?). Stimuli were presented in either the left (LVF) or right (RVF) visual field. When the classification was made on the basis of the fundamental frequencies (1 or 3 c/deg), there was a LVF/right hemisphere advantage. However, when the classification was on the basis of a sharp/fuzzy distinction which involved searching for the higher harmonic frequencies, then a RVF/left hemisphere advantage was found.     

An exploratory study of videotapes of long-term group psychotherapy of outpatients with major and chronic mental illness

This study explored patterns emerging in videotaped sessions of group psychotherapy with seven outpatients of a large mental health facility. The 22 sessions spanned the 12th to 27th months of the group's existence. Group members had long histories (25–50 years) of symptoms characteristic of schizophrenia. Each session was rated on the Group Environment Scale. One session from a group in its earlier stages was also rated on the same instrument to give some indication of baseline patterns. Analyses of changes across the 15 months were not statistically significant. However, some GES subscales, including Cohesion, Independence, and Self-Discovery, showed relatively high mean levels across the 15-month period. These elevations are discussed as suggesting the codevelopment of orientations that have sometimes been viewed as incompatible and unattainable for schizophrenics. Interpreted clinically, the GES patterns help to elaborate recent findings about the relatively good success of long-term group therapy with such populations. The study, although merely suggestive, illustrates the potential for gleaning solid and clinically useful data from group psychotherapy research.The authors would like to thank Drs. Jill Rierdan, Nina Fieldsteel, Joseph Christy, and an anonymous reviewer for their suggestions, Kendra Bryant for serving as the reliability rater, and Janet Eltinge for her skilled videotaping.     

An evaluation of a brief integrity test user orientation program

The purpose of this pilot study was to assess the effectiveness of a brief test user orientation program on increasing service station managers' familiarity with a few key employment testing issues, including their familiarity with theModel Guidelines for Preemployment Integrity Testing Programs. The obtained results reveal that even a brief orientation program was able to significantly increase the managers' stated degree of familiarity with testing issues.     

Parent-tutoring procedures: Experimental analysis and validation of generalization in oral reading across passages,settings, and time

A study that involved parents as reading tutors was carried out at home during the summer with four elementary children, three with learning disabilities. One purpose was to determine the effects of tutoring in the basal reader on reading rates at home. Another purpose was to determine potential generalization effects as a result of parent tutoring on different academic tasks at home and, later at school, on different and similar tasks. A combination multiple-baseline and reversal design tested for replication and generalization effects. Increases in correct rates were noted for the targeted variables across conditions. The results indicated that parents tutoring with school basal texts during the summer produced marked increases in reading rates that generalized at home to different academic tasks and at school to different and similar tasks. This suggests that parents, when using specific tutoring procedures, can increase their children's academic skills.